Risk prediction in diffuse large B-cell lymphoma improves when combining baseline PET features with interim PET response.

Accurate detection of patients at high risk of treatment failure following first line immunochemotherapy in diffuse large B-cell lymphoma (DLBCL) is of paramount importance as patients might benefit from early treatment escalation. Recently, we introduced the International Metabolic Prognostic Index (IMPI) based on metabolic tumor volume (MTV), age and stage that outperformed the International Prognostic Index. However, radiomic features such as the maximum distance between the largest lesion and another lesion (Dmaxbulk) or the peak standardized uptake value (SUVpeak) along with early treatment response at interim positron emission tomography (iPET) based on ΔSUVmax may have additional predictive value.

The predictive role of interim positron emission tomography for Hodgkin lymphoma treatment outcome is confirmed using the interpretation criteria of the Deauville five-point scale.

A retrospective, international, multicenter study was undertaken to assess: (i) the prognostic role of 'interim' positron emission tomography performed during treatment with doxorubicin, bleomycin, vinblastine and dacarbazine in patients with Hodgkin lymphoma; and (ii) the reproducibility of the Deauville five-point scale for the interpretation of interim positron emission tomography scan. Two hundred and sixty patients with newly diagnosed Hodgkin lymphoma were enrolled. Fifty-three patients with early unfavorable and 207 with advanced-stage disease were treated with doxorubicin, bleomycin, vinblastine and dacarbazine ± involved-field or consolidation radiotherapy.